Laserfiche WebLink
AP�'LICATION FOR RIGHT•OF-WAY USE PERMIT <br /> everefl . <br /> e 106�0 <br /> CITY ENGINEEHS <br /> EVERETT,WASHINGTON PERMITNU. ' ' <br /> The Undersigned � ' � � -� � �.. <br /> , Hereby applies for pertnission to ��.+ -.��• � �� � � � � !���� nr, � i''- ?��i: � I <br /> , At the following location '�: i ��. 1� �:/,,: �: f„, ? � - � <br /> J I <br /> SKETCH i <br /> (Work to be done) I <br /> i <br /> '� -----L---' .: �. f(-n<'1 '�i�o•� I� <br /> ; --- rr ,t• <br /> I i <br /> ' - -------- - I <br /> �i _ .I� , �..., � <br /> � � ' i <br /> , ; <br /> ; <br /> ,�ar �• I" j . <br /> � ��� �" � ���� <br /> � \� , <br /> � � ��. � <br /> I \\ J. ,, ' \. ".-.J .. I�i, .r l,o i <br /> \ �nG7C�I �•t.I.' <br /> \ �r�trL�� Cwn..r �'o \ .,.�r"•• r L.S F'r 'r�Y�- I <br /> � �\ � �r.�.��ec� 7��� idc�� S�de ��� p� : nr,> P�� ; <br /> \\ �,;�.,iG�r � � <br /> _,r . ����\� � - ---�-. _ .. ' <br /> ' � ----..�--_;�_. ----------�- -----�-- <br /> , � -;�-. � � _ <br /> � � <br /> ._.'___'._`1'" _._"'_' __'"_"""_�_��°�rl��r1 Lc7t9 (2__ _.___._. .. II <br /> 9 � <br /> r.Y� I <br /> � <br /> DRrvEwaY SECTION The undersigned own.:r hereby agrees to ho�d and ' <br /> NO SCA�E save harmless the Ciry of Everett from any and all '�, <br /> '� f'-- � claims tor damages thal may arise because of installa- ' <br /> � i" LIP tion and maintenance of the improvement hereto <br /> app(ied for and further agrees ro remove same upon <br /> � 30�.�---�--}--30-.� notice-from the City and to replac� public property , <br /> � damaged thereby. .__. . <br /> �I Signature of Applicant � <br /> COPY OF THIS APPLICATION TO � Address , � <br /> BE POSTED ON JOBSITE. <br /> CALL ENGINEERING DEPT. 259�8811 I Telephone Number . � <br /> 24 HOURS QE1=0R[ CONSTRUCTIOfJI Date ' ' <br /> - - _ _ _ _ _ _ _ � ' . �-:__.... ./ ;; %-�� <br /> � CHECKU:•I' Fce ' f� <br /> Water Valve Dept. Approvals <br /> Drainage � � � <br /> � Curb&Gutter .- Engineers _ �� � '. <br /> , Sidewalk WaterL�_.1�.-..:� f��4:��v�„i I1�� ��. t ti�C. �, <br /> ///��� O Street <br /> � � � � � ��� � Communications <br /> Inspector's ignature <br /> Traf tic <br /> ��� �Plannirig, � <br /> —iSateV �. ,i�_ ._ !_� �,��_. . � I�Ir�� • ` �-. <br /> Remarks <br /> Note: Original to Customer �. <br /> � 1 Copy to File , ��� a � � <br /> 1 Capy lo Inspector Approved by , � . <br /> Date Approved � <br />